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Coffee is brain foodPeople still seem to think that coffee is bad for you. Perhaps it's our assumption that anything that we enjoy can't possibly be good for us. In past Health & Nutrition Bites we've seen that coffee may help improve blood sugar control, lower circulating uric acid, reduce your risk of colon cancer, and is associated with a reduced risk of death from heart disease.

Drink coffee, live longerCoffee is one of, if not the most widely consumed beverages in the world, so it's no surprise that there's been lots of research into its effects on human health. It's brain food, may help prevent gout attacks and improve your blood sugar control (important for diabetics), reduces your risk of colon cancer, and reduces markers of inflammation, which are linked to your risk of cancer and heart disease.

Drinking Coffee Reduces Your RiskYet another study has come out that supports drinking regular coffee. In the American Journal of Clinical Nutrition (2006;83(5):1039-46), Dr. Lene Frost Andersen and colleagues studied the relationship between coffee drinking and diseases like cardiovascular disease, cancer (other than skin cancer), Parkinson's disease, gallstones, cirrhosis of the liver, and diabetes. These diseases have a strong inflammatory component, and coffee is known to be a major source of antioxidants in the diet.

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Coffee and your heart

In spite of the tons of research to the contrary, people persist in thinking that coffee is bad for them. I can only guess that people think that something they enjoy so much can't possibly be good for them.

Certainly there hasn't been a long term randomized controlled trial in which people were served specific amounts and types of coffee for decades, but the epidemiological data is definitely piling up, especially with this latest article in the American Journal of Clinical Nutrition (2017;106:1113-20)

This study out of the Netherlands made use of data gathered initially for a study known as the Alpha Omega Study. The over 4,800 men and women recruited for that study were between 60 and 80 years old at the start of the study (in 2002) and had experienced a diagnosed heart attack in the prior ten years. For that study the participants were randomly assigned to receive either omega-3 fatty acid supplements or a placebo for three years, with the participants' health monitored for the duration of the study as well as for an additional ~7 years.

At the start of the initial study the participants responded to a detailed dietary questionnaire which included specific questions on coffee intake, including types of preparations such as caffeinated or decaffeinated coffee, instant coffee, specialty drinks such as cappuccinos, or Viennese blend. Unlike other studies on coffee, this questionnaire asked the participants to specify how much coffee they considered to be a cup (whether it was ~4.5 ounces, 5 ounces, or 6.6 ounces) as well as whether they added anything to their coffee, such as milk, cream, coffee creamer, or sugar (although they did not ask about artificial sweeteners).

As you'd expect, the original study's authors collected demographic, health, and lifestyle information as well as measuring height and weight and performing blood tests.

After about ten years (average length of follow-up was about 7 years due to a 3-year enrollment period), the authors could access the Dutch National Mortality Registry, which allowed the authors to identify the cause of death for all of the study participants who perished over the course of the study. The deceased's coffee intake and other factors could then be compared with those still living at the end of the study.

Compared to those who consumed 2 cups of coffee or less per day, those who drank more than 4 cups of coffee per day were 28% less likely to die from cardiovascular disease, 32% less likely to die of ischemic heart disease, and 18% less likely to die of any cause. This was a dose-response relationship, meaning that increasing levels of coffee meant correspondingly lower risk of death. This held true regardless of whether the coffee was caffeinated or decaffeinated, the participants' Body Mass Index, smoking status, and whether they had been assigned to receive omega-3 fatty acids or placebo, and the association remained relevant even when the authors analyzed those who only drank decaffeinated coffee (or the reverse).

What's particularly important about this study is that the authors took care to specify what participants meant by "a cup of coffee" and could also take into account the type of coffee drunk and whether participants added anything to their coffee, including milk or cream and sugar. The authors note that while they did not ask about how the coffee was brewed, "most coffee in the Netherlands is paper filtered."

A few caveats here, however: First, 79% of the participants were men, so these findings may not be as strongly applicable to women. Second, all of the participants had already experienced a myocardial infarction (heart attack), so it's possible that they changed their coffee consumption or other dietary habits in response to their illness.

What this means for you

The preponderance of evidence (and there's a lot of it) says that coffee is good for you, period. Stop talking about coffee as if it were a guilty pleasure - indeed, if anything should be a guilty pleasure it should be sugar-sweetened beverages, which we know are bad for you. (Interestingly, those who drank the most coffee in this study drank the least sugar-sweetened beverages.) Use additives in your coffee drinks with care for the amount of sugar and calories they contain, but you're far better off having a cup of coffee than a soda.